| NPI | 1376976449 |
|---|---|
| Other Name | ADULT ADN FAMILY DENTISTRY OF FOUNTAIN CITY |
| Entity Type | Organization |
| Authorized Contact | RANDALL FORD President 865-591-4829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2013-08-13 |